(WOMENSENEWS)--Tracy had been enduring physical abuse from her partner--sometimes he would shove her or grab her arm--but she didn't really feel threatened. Then he put his hands on her throat and tried to strangle her. Tracy got scared.

Though she didn't pass out, she felt powerless and frightened for her life. The fear drove her to seek help, and she went to the hospital, where a doctor referred her to a battered women's advocate. She made a safety plan, and eventually she decided to leave the relationship. The moment her partner tried to strangle her, Tracy said, was a turning point.

Tracy was right. Women whose abusers try to strangle them are more likely than other abused women to be murdered. And even when a woman isn't killed, if the abuser chokes or strangles her, future violence is likely to be more severe.

Nurses, police officers and others need to know facts like this one so they can help abused women assess how much danger they're in, says Carolyn Rebecca Block, lead researcher on a yet-to-be-published study examining which women are most likely to be killed by their partners.

Some high-danger situations--like being threatened with a knife or gun--are well known. But others, like attempted strangulation, are only now becoming clear.

The fact that an abused woman asks for help from official quarters is a sign that the violence is severe, the investigation found. More than half of murder victims studied had sought official help, primarily from medical staff or police, suggesting not only that those law enforcement officers and health care workers play vital roles in linking abused women to resources, but also that opportunities to intervene are missed.

The Chicago Women's Health Risk Study, conducted by the Illinois Criminal Justice Information Authority and funded by the National Institute of Justice, looked at the lives of the 87 Chicago women who were killed by--or who themselves had killed--boyfriends, husbands, lovers or former partners in 1995 and 1996. It also followed 497 women who visited Chicago hospitals and clinics for any kind of health care and who had been abused in the previous year.

Male partners or ex-partners kill 1,000 to 1,500 women each year in the United States, according to FBI statistics; most of the murders come after a pattern of escalating abuse.

Confirmed: Controlling Men Often Hurt Women

Many of the study's findings confirm what those who work with battered women already know; other findings may challenge common beliefs.

For example, in 15 percent of the Chicago murders, there had been no previous violence in the relationship. In those cases, the most important risk factors were the partner's controlling behavior, especially jealousy, as well as drug use and violent actions outside the home.

If a boyfriend or husband displays those behaviors, says Block, "it's just what your mother told you: 'This is not a good kind of guy to go out with. Go find someone else.'"

Mothers, sisters, neighbors, co-workers and friends can be "encouraged to say that now," Block says, because the evidence backs them up.

A few key questions can help reveal how much danger a woman faces. If a woman is abused, the study says, ask her: Were you choked or strangled? Where you threatened with a gun or knife? Has the violence been getting more frequent?

If she isn't abused, ask her: Is your partner violent outside the home? Does your partner use drugs, control your activities or frequently express jealousy?

If the answer to any of these questions is "yes," the danger is greater.

Kim Riordan, co-director of a crisis intervention project for the Chicago Abused Women Coalition, says the answers to those questions provide advocates and the women themselves with more information. "Knowledge is power," Riordan says. "It can help inform a woman's decision-making about what she needs to do."

Knowing the top risks allows Riordan and other advocates to give the women they're working with the tools to help them make decisions. Says Riordan, advocates and counselors can say things like, "I don't want to scare you, but I want to let you know that this can result in very serious injuries or even death."

A Struggle to Get Health Providers to Focus on Partner Abuse

It's a struggle even to get health care providers to focus on partner abuse as a health problem, says Riordan. It's not universal even in Cooke County Hospital, never mind nationally, she adds.

"We're lucky if we can get providers to ask very basic questions in initial screenings," Riordan says.

At Erie Family Health Center, one of the research sites, health workers now spend several sessions with a battered woman, working on a safety plan, exploring options and teaching about legal rights and other resources. "That way she feels she has more options and is more empowered to make a decision," says Eva Hernandez-Thomas, a therapist at the clinic.

While Hernandez-Thomas is happy that the clinic is identifying more abused women, she's dismayed that "the support systems are nowhere to be found."

"What is worse?" asks Hernandez-Thomas. "Not to identify the women, or not to be able to help them? I pray to God that with this evidence we can get more funding for prevention, early intervention and accommodations."

Lauren R. Taylor is a free-lance writer and self-defense instructor based in Silver Spring, Md.

For more information:

The Chicago Women's Health Risk Study report, Illinois Criminal Justice Information Authority:
At a glance (PDF, 52KB):
http://www.icjia.state.il.us/public/pdf/cwhrs/glance2000.pdf
Full report (PDF, 905KB):
http://www.icjia.state.il.us/public/pdf/cwhrs/cwhrs.pdf

Family Violence Prevention Fund:
http://www.endabuse.org/

National Domestic Violence Hotline:
Voice: 1-800-799-SAFE (7233). TTY: 1-800-787-3224